我國六個(gè)縣0~15歲人群腸道病毒71型和柯薩奇病毒A組16型中和抗體水平研究
發(fā)布時(shí)間：2019-06-22 16:16
【摘要】：目的通過對六個(gè)縣0-15歲人群腸道病毒71型(Enterovirus Type71, EV71)和柯薩奇病毒A組16型(Coxsakievirus Group A Type16, CVA16)中和抗體(Neutralizing Antibody, NA)水平的調(diào)查,了解該人群的EV71和CVA16NA水平分布特征：通過母嬰配對的EV71和CVA16NA水平調(diào)查,了解母嬰EV71和CVA16NA水平分布特征;為制定EV71滅活疫苗的免疫程序提供參考。方法選取廣西、江蘇兩省的六個(gè)縣作為研究現(xiàn)場,在每個(gè)縣選取一個(gè)手足口病(Hand-Foot-Mouth Disease, HFMD)高發(fā)鄉(xiāng)和一個(gè)HFMD低發(fā)鄉(xiāng),采用系統(tǒng)隨機(jī)抽樣的方法選取符合條件的研究對象(新生兒及母親組除外),對選取的0～15歲人群及新生兒母親采集靜脈血標(biāo)本,并對他們(或其家長)進(jìn)行問卷調(diào)查。采用中和試驗(yàn)對血標(biāo)本進(jìn)行EV71和CVA16NA檢測。結(jié)果1.EV71NA水平：1.1所有調(diào)查對象的EV71NA陽性率為48.7%。不同年齡組EV7I NA陽性率的變化趨勢為：新生兒的EV71NA陽性率較高(75.2%),隨后逐漸降低,至6月齡降至最低(10%);≥1歲各年齡組的EV71NA陽性率迅速上升,其中6～10歲組的陽性率最高(87.5%)。各縣及不同性別各年齡組的EV71NA陽性率變化趨勢與總的變化趨勢相似。1.2六個(gè)縣全部調(diào)查對象的EV71NA幾何平均滴度(Geometric MeanTiter,GMT)為1：17.70,1月齡至9～11月齡的EV71NA GMT均≤1：10,其中5月齡組最低(1：5.10)；1歲各年齡組的EV71NAGMT上升,其中4歲組最高(1：95.77)。不同縣及不同性別各年齡組的EV71NAGMT曲線與總的EV71NAGMT曲線相似。1.3既往有病史者的EV71NA陽性率及GMT分別為77.3%和1：232.91,既往無病史者的EV71NA陽性率和GMT分別為48.4%和1：17.35,既往有病史者的EV71NA陽性率和GMT均高于既往無病史者(X2=7.2545,P=O.0071；t=6.49,P0.0001)。2.CVA16NA水平：六個(gè)縣的CVA16陽性率及GMT普遍偏低。2.1全部調(diào)查對象的CVA16NA陽性率為34.7%。不同年齡組CVA16NA陽性率的變化趨勢為：1歲各月齡組調(diào)查對象的CVA16NA陽性率隨年齡的增長而下降,其中9-11月齡組最低(7.1%)；≥1歲各年齡組CVA16NA陽性率逐漸上升,其中6-10歲組的CVA16NA陽性率最高(72.1%)。不同年齡、不同縣調(diào)查對象的CVA16NA陽性率差異均有統(tǒng)計(jì)學(xué)意義,但男、女性(VA16NA的陽性率差異無統(tǒng)計(jì)學(xué)意義。2.2六個(gè)縣全部調(diào)查對象的CVA16NAGMT為1：8.44,≤1歲各年(月)齡組的CVA16NA GMT均較低(1：10),1歲各年齡組CVA16NA GMT上升,5歲組最高(1：22.97)。各縣及不同性別的分年齡組NAGMT曲線與總NA的GMT曲線相似。2.3不同病史者的CVA16NA陽性率及GMT差異均無統(tǒng)計(jì)學(xué)意義(χ2=1.1414,P0.2845;t=I.4,P=0.1771)。3.與CVA16NA陽性率及GMT相比,除4月齡、5月齡、6月齡、7月齡、8月齡、1歲組及蒙山縣外,EV71NA陽性率及GMT均較高。4.母親EV71和CVA16的NA陽性率和GMT分別為83.5%、33.1%和1：26.61、1：6.11,新生兒EV71和CVA16的NA陽性率和GMT分別為75.2%、35.5%和1：22.05、1：6.97,母嬰EV71、CVA16的NA陽性率及GMT差異均無統(tǒng)計(jì)學(xué)意義(X2EV71=2.52,P=0.1124;X2CVA16=0.1650, P=0.6846; tEV71=1.05, P=0.2953;tCVA16=1.30P=0.1946)。 EV71、CVA16NA陽性率和GMT在HFMD高、低發(fā)縣差異也無統(tǒng)計(jì)學(xué)意義(X2EV71=1.45, P=0.2288; X2CVA16=1.28,P=0.2538; tEV71=1.86,P=0.0643; tCVA16=0.2P=.8399)。母嬰EV71和CVA16NA滴度均存在相關(guān)性(rEV71=0.69,P0.0001;rCVA16=0.48,P0.0001)。5.部分調(diào)查對象存在EV71和(CVA16NA雙陽性情況。EV71和CVA16NA雙陽性率、EV71NA單陽性率、CVA16NA單陽性率及EV71和CVA16NA雙陰性率分別為24.8%、23.9%、9.9%和41.4%。結(jié)論1.5～6月齡兒童的母傳抗體衰減至最低：1歲開始EV71自然感染率明顯升高。2.六個(gè)縣0～15歲人群的CVA16NA陽性率及GMT均較低,有發(fā)生由CVA16引起的HFMD暴發(fā)的危險(xiǎn)。3.母親的EV71和CVA16NA陽性率及GMT高,新生兒的陽性率和GMT也會相應(yīng)的高,母傳抗體是預(yù)防小年齡組兒童發(fā)病的主要因素,可為生命早期的嬰兒提供有效保護(hù)。4.母傳EV71和CVA16NA滴度較低,而自然感染獲得的EV71和CVA16NA滴度較高。5.EV71和CVA16存在大量隱性感染的情況。6.該六個(gè)縣近幾年HFMD病原體EV71的流行率高于CVA16。
[Abstract]:Objective To investigate the horizontal distribution of EV71 and CVA16NA in six counties from 0 to 15 years of age, including Enterovirus type 71 (EV71) and Coxsackie virus A group 16 (CVA16), and to investigate the horizontal distribution of EV71 and CVA16NA of the population: the horizontal survey of EV71 and CVA16NA by mother-to-child pairing, To understand the characteristics of maternal and infant EV71 and CVA16NA levels, and to provide reference for the development of the immune procedure for EV71 inactivated vaccines. Methods Six counties of Guangxi and Jiangsu were selected as the study site. One hand and foot-foot-mouth disease (HFMD) and one HFMD were selected in each county. Venous blood samples were collected from the selected 0-15-year-old population and the newborn's mother, and a questionnaire was conducted to them (or their parents). The blood samples were tested by neutralization test with EV71 and CVA16NA. Results 1. EV71NA level: 1.1 The EV71NA positive rate of all the investigated subjects was 48.7%. The positive rate of EV7I in the different age group was higher (75.2%), and then gradually decreased to the lowest (10%). The positive rate of EV71NA in all age groups in the 1-year-old age group increased rapidly, and the positive rate of EV71 in the 6 to 10-year-old group was the highest (87.5%). The trend of EV71NA positive rate in all counties and different sex groups was similar to that in the overall trend. The geometric mean titer (GMT) of EV71NA of all the survey subjects in the six counties was 1: 17.70, and the EV71NA GMT of 1 month to 9-11 months was 1:10, with the lowest (1: 5.10) in the 5-month-old group; The 1-year-old age group's EV71NAGMT rose, with the highest (1: 95.77) in the 4-year-old group. The EV71NAGMT curve of each age group in different counties and different sexes was similar to that of the overall EV71NAGMT curve. 1.3 The positive rate of the EV71NA and the GMT of the previous medical history were 77.3% and 1: 232.91, respectively. The positive rate of the EV71NA and the GMT of the prior non-medical history were 48.4% and 1: 17.35, respectively. The positive rate of EV71 NA and GMT of the prior medical history were higher than those of the prior non-medical history (X2 = 7.2545, P = O.0071; t = 6.49, P.0001).2. CVA16NA: the positive rate of CVA16 and GMT in six counties was generally lower. 2.1 The positive rate of CVA16NA in all the investigated subjects was 34.7%. The positive rate of CVA16NA in different age groups was: the positive rate of CVA16NA in the 1-year-old group decreased with the increase of age, of which 9-11-month-old group was the lowest (7.1%), and the positive rate of CVA16NA in all age groups in the 1-year-old group was increasing, and the positive rate of CVA16NA in the 6-10-year-old group was the highest (72.1%). There was a significant difference in the positive rate of CVA16NA in different age and in different counties, but the positive rate of the male and female (VA16NA) was not statistically significant. The CVA16NAGMT of all the survey subjects in the six counties was 1: 8.44, and the CVA16NA GMT of the first year of the year (month) was lower (1: 10) The CVA16NA GMT in the 1-year-old age group was up and the 5-year-old group was the highest (1: 22.97). The positive rates of CVA16NA and GMT of different patients with different medical history were not statistically significant (Sup2 = 1.1414, P0.2845; t = I.4, P = 0.1771). Compared with the positive rate of CVA16A and GMT, the positive rate and GMT of EV71NA were higher than that of the 4-month-old,5-month-old,6-month-old,7-month-old,8-month-old,1-year-old group and Mengshan county. The positive rates of NA and GMT of the mothers EV71 and CVA16 were 83.5%, 33.1% and 1: 26.61,1: 6.11, the positive rates of NA and GMT of the neonates EV71 and CVA16 were 75.2%, 35.5% and 1: 22.05,1: 6.97, and the positive rates of NA and GMT of the mother and child EV71 and CVA16 were not statistically significant (X2EV71 = 2.52, P = 0.1124; X2CVA16 = 0.1650, P = 0.6846; tEV71 = 1.05, P = 0.2953; tCVA16 = 1.30 P = 0.1946). The positive rates of EV71, CVA16A and GMT were not significant (X2EV71 = 1.45, P = 0.2288; X2CVA16 = 1.28, P = 0.2538; tEV71 = 1.86, P = 0.0643; tCVA16 = 0.2P =.8399). There was a correlation between the titer of EV71 and CVA16NA (rV71 = 0.69, P.0001; rCVA16 = 0.48, P0.001). Some of the investigated subjects were EV71 and (CVA16NA double positive). The positive rate of EV71 and CVA16NA, the positive rate of EV71 NA, the positive rate of CVA16NA and the double negative rate of EV71 and CVA16NA were 24.8%, 23.9%, 9.9% and 41.4%, respectively. Conclusion The maternal antibody of children from 1.5 to 6 months of age is attenuated to the minimum: the natural infection rate of EV71 is increased obviously at the age of 1. The positive rate and GMT of CVA16NA in six counties from 0 to 15 years were lower, and there was a risk of an outbreak of HFMD caused by CVA16. The positive rate of EV71 and CVA16A of the mother and the GMT are high, and the positive rate and GMT of the newborn are also high. The maternal antibody is the main factor to prevent the incidence of children in the small age group, and can provide effective protection for infants in the early stage of life. The titres of EV71 and CVA16A were lower, and the titers of EV71 and CVA16NA obtained by natural infection were higher.5. There was a large number of recessive infections in EV71 and CVA16. The prevalence of HFMD pathogen EV71 in the six counties has been higher than that of CVA16 in recent years.
【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R725.1
本文編號：2504755
[Abstract]:Objective To investigate the horizontal distribution of EV71 and CVA16NA in six counties from 0 to 15 years of age, including Enterovirus type 71 (EV71) and Coxsackie virus A group 16 (CVA16), and to investigate the horizontal distribution of EV71 and CVA16NA of the population: the horizontal survey of EV71 and CVA16NA by mother-to-child pairing, To understand the characteristics of maternal and infant EV71 and CVA16NA levels, and to provide reference for the development of the immune procedure for EV71 inactivated vaccines. Methods Six counties of Guangxi and Jiangsu were selected as the study site. One hand and foot-foot-mouth disease (HFMD) and one HFMD were selected in each county. Venous blood samples were collected from the selected 0-15-year-old population and the newborn's mother, and a questionnaire was conducted to them (or their parents). The blood samples were tested by neutralization test with EV71 and CVA16NA. Results 1. EV71NA level: 1.1 The EV71NA positive rate of all the investigated subjects was 48.7%. The positive rate of EV7I in the different age group was higher (75.2%), and then gradually decreased to the lowest (10%). The positive rate of EV71NA in all age groups in the 1-year-old age group increased rapidly, and the positive rate of EV71 in the 6 to 10-year-old group was the highest (87.5%). The trend of EV71NA positive rate in all counties and different sex groups was similar to that in the overall trend. The geometric mean titer (GMT) of EV71NA of all the survey subjects in the six counties was 1: 17.70, and the EV71NA GMT of 1 month to 9-11 months was 1:10, with the lowest (1: 5.10) in the 5-month-old group; The 1-year-old age group's EV71NAGMT rose, with the highest (1: 95.77) in the 4-year-old group. The EV71NAGMT curve of each age group in different counties and different sexes was similar to that of the overall EV71NAGMT curve. 1.3 The positive rate of the EV71NA and the GMT of the previous medical history were 77.3% and 1: 232.91, respectively. The positive rate of the EV71NA and the GMT of the prior non-medical history were 48.4% and 1: 17.35, respectively. The positive rate of EV71 NA and GMT of the prior medical history were higher than those of the prior non-medical history (X2 = 7.2545, P = O.0071; t = 6.49, P.0001).2. CVA16NA: the positive rate of CVA16 and GMT in six counties was generally lower. 2.1 The positive rate of CVA16NA in all the investigated subjects was 34.7%. The positive rate of CVA16NA in different age groups was: the positive rate of CVA16NA in the 1-year-old group decreased with the increase of age, of which 9-11-month-old group was the lowest (7.1%), and the positive rate of CVA16NA in all age groups in the 1-year-old group was increasing, and the positive rate of CVA16NA in the 6-10-year-old group was the highest (72.1%). There was a significant difference in the positive rate of CVA16NA in different age and in different counties, but the positive rate of the male and female (VA16NA) was not statistically significant. The CVA16NAGMT of all the survey subjects in the six counties was 1: 8.44, and the CVA16NA GMT of the first year of the year (month) was lower (1: 10) The CVA16NA GMT in the 1-year-old age group was up and the 5-year-old group was the highest (1: 22.97). The positive rates of CVA16NA and GMT of different patients with different medical history were not statistically significant (Sup2 = 1.1414, P0.2845; t = I.4, P = 0.1771). Compared with the positive rate of CVA16A and GMT, the positive rate and GMT of EV71NA were higher than that of the 4-month-old,5-month-old,6-month-old,7-month-old,8-month-old,1-year-old group and Mengshan county. The positive rates of NA and GMT of the mothers EV71 and CVA16 were 83.5%, 33.1% and 1: 26.61,1: 6.11, the positive rates of NA and GMT of the neonates EV71 and CVA16 were 75.2%, 35.5% and 1: 22.05,1: 6.97, and the positive rates of NA and GMT of the mother and child EV71 and CVA16 were not statistically significant (X2EV71 = 2.52, P = 0.1124; X2CVA16 = 0.1650, P = 0.6846; tEV71 = 1.05, P = 0.2953; tCVA16 = 1.30 P = 0.1946). The positive rates of EV71, CVA16A and GMT were not significant (X2EV71 = 1.45, P = 0.2288; X2CVA16 = 1.28, P = 0.2538; tEV71 = 1.86, P = 0.0643; tCVA16 = 0.2P =.8399). There was a correlation between the titer of EV71 and CVA16NA (rV71 = 0.69, P.0001; rCVA16 = 0.48, P0.001). Some of the investigated subjects were EV71 and (CVA16NA double positive). The positive rate of EV71 and CVA16NA, the positive rate of EV71 NA, the positive rate of CVA16NA and the double negative rate of EV71 and CVA16NA were 24.8%, 23.9%, 9.9% and 41.4%, respectively. Conclusion The maternal antibody of children from 1.5 to 6 months of age is attenuated to the minimum: the natural infection rate of EV71 is increased obviously at the age of 1. The positive rate and GMT of CVA16NA in six counties from 0 to 15 years were lower, and there was a risk of an outbreak of HFMD caused by CVA16. The positive rate of EV71 and CVA16A of the mother and the GMT are high, and the positive rate and GMT of the newborn are also high. The maternal antibody is the main factor to prevent the incidence of children in the small age group, and can provide effective protection for infants in the early stage of life. The titres of EV71 and CVA16A were lower, and the titers of EV71 and CVA16NA obtained by natural infection were higher.5. There was a large number of recessive infections in EV71 and CVA16. The prevalence of HFMD pathogen EV71 in the six counties has been higher than that of CVA16 in recent years.
【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R725.1
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 王海巖,許文波,徐愛強(qiáng),朱貞,楊會利,李巖,紀(jì)峰,崔愛利,張勇;一起傳染病暴發(fā)中腸道病毒血清型鑒定和ECHO30基因特征分析[J];病毒學(xué)報(bào);2005年02期
2 舒建癡,唐耀武,王德生,朱紅,劉海林,曹逸云,陽選祥,薛桂玲,鄭新華,陸桂秋;北京發(fā)現(xiàn)由CoxA_(16)病毒引致的一次手足口病[J];北京醫(yī)學(xué);1986年04期
3 陳先君;;重癥手足口病患兒的早期識別和護(hù)理[J];第三軍醫(yī)大學(xué)學(xué)報(bào);2010年02期
4 江慧敏;高媛媛;林海生;鄭可魯;楊思達(dá);;兒童危重癥手足口病43例臨床特點(diǎn)分析[J];廣州醫(yī)藥;2010年03期
5 郭振平;劉瑩;王立群;趙桂讓;崔士磊;吳昊;田鵬;麻順廣;鄭艷麗;宋彩娟;李夢秋;唐振強(qiáng);許汴利;李蓬;;5歲以下兒童監(jiān)護(hù)人對手足口病防治知識認(rèn)知情況調(diào)查[J];河南預(yù)防醫(yī)學(xué)雜志;2011年06期
6 李靖;楊旭;李冬梅;;重型手足口病患兒的救治與護(hù)理[J];吉林醫(yī)學(xué);2010年02期
7 張嫦蓮;;手足口病患兒的護(hù)理[J];全科護(hù)理;2010年06期
8 繆曉輝;;腸道病毒71型疫苗的臨床意義重大[J];微生物與感染;2010年04期
9 鄺璐;王長兵;梁卓夫;鐘家禹;肖密絲;朱冰;;廣州地區(qū)健康兒童腸道病毒71型抗體水平調(diào)查[J];中國循證兒科雜志;2011年03期
10 種艷秋;冷榮新;盧朝暉;王敏;秦詠梅;王寧;胡琬;;國內(nèi)1998～2007年手足口病文獻(xiàn)計(jì)量分析[J];醫(yī)學(xué)信息學(xué)雜志;2009年05期
，本文編號：2504755
本文鏈接：http://sikaile.net/yixuelunwen/eklw/2504755.html
最近更新
教材專著
